About 25% of Americans are at risk for type 2 diabetes – and most of us have no idea. A poor diet, not exercising enough, even aging raise our likelihood. Fortunately, simple efforts to improve our health can make a big difference. Read on for 13 prevention tips...

How serious a health problem is type 2 diabetes, the most common form of this incurable disease?

Very.

About 24 million people in the U.S. have it, and by 2034, that number will jump to 44 million, says University of Chicago researchers in one study.

This disease, in addition to affecting our families, will strain the U.S. health system, costing $336 billion per year by 2034, they expect.

“Women who are overweight or obese are more at risk,” says Josefina Diaz, M.D., formerly chief of endocrinology at Saint Joseph Hospital in Chicago.

Aging, especially after 45, and being physically inactive are other major factors.

You can’t be cured of diabetes, but you can make lifestyle changes to help prevent diabetes. That’s good news for the more than 57 million people in the U.S. who have prediabetes (higher than normal blood sugar levels that could lead to the disease), according to the U.S. Department of Health and Human Services.

Will changing your routine really make a difference? Yes!

In fact, major diet and exercise changes reduced risk for 58% of people with prediabetes, according to a 10-year Diabetes Prevention Program (DPP) by the National Institutes of Health.

We need insulin to change food into energy. Without it, sugar stays in the bloodstream and, at high levels, causes diabetes, which can then turn into other problems.

“It can lead to heart attack and stroke, dementia, Alzheimer's disease, many types of cancers and complications including blindness, kidney failure and limb amputation,” says Fred Vagnini, M.D., medical director of The Heart, Weight Loss and Diabetes Center in New York and author of The Weight Loss Plan for Beating Diabetes (Fair Winds Press).

Read on for the latest studies and expert-recommended guidelines on how to stop this disease before it starts...

1. Get moving
Physical activity lowers blood sugar and boosts your sensitivity to insulin. Research shows both aerobic exercise and resistance training can help control diabetes, but you’ll get the best benefits if you do various types of exercise, according to the American Diabetes Association (ADA).

The ADA recommends a half-hour of mild aerobic activity (like dancing or tennis) five times per week, based on results from a landmark, 16-year study by the Harvard School of Public Health. That study found that even brisk daily walking reduces risk of type 2 diabetes by 30%.

Why resistance training? Because muscle is a good absorber of blood sugar (which gets it out of the bloodstream).

Do a full-body workout – engaging chest, back, butt and legs – for 30 minutes twice a week, says Melina Jampolis, M.D., a member of the CNN Health team.

“You need to challenge yourself and change things up to keep getting a benefit from it,” she says.

You don’t have to hit the gym, adds Howard Shapiro, M.D., author of Eat and Beat Diabetes With Picture-Perfect Weight Loss (Harlequin).He says activities such as cleaning the house and carrying groceries help too.

2. Go for whole grains
White bread, white rice and potatoes aren’t just bad for our waistlines: They all have a high glycemic index, which can cause spikes in blood sugar and insulin levels.

Studies, including the large Shanghai Women’s Health Study in China (that followed 75,000 women), found that women whose diets had the highest glycemic index had a 21% higher risk of developing type 2 diabetes compared with those whose diets had a low glycemic index.

Counting carbs and switching to whole grains can help.

Whole-grain bread, pasta and cereals – but not the sugary kind – are all good when it comes to diabetes prevention, because they slow down carb absorption.

Studying 160,000 nurses in two studies, Harvard School of Public Health researchers found those who averaged 2-3 servings of whole grains a day were 30% less likely to develop type 2 diabetes than those who rarely ate whole grains.

You may also want to take a fiber supplement, such as Metamucil (but again, choose sugar free).

Can’t give up carbs? Read on…

3. Pour a spoonful of vinegar
Two tablespoons of apple cider vinegar a day lowers the blood sugar surge you get eating from eating carbs, thereby lowering your blood sugar, according to a series of studies by Carol Johnston, Ph.D., professor and director of the Nutrition Program at Arizona State University.

Johnston recommends making a vinaigrette with 2 parts vinegar to 1 part olive oil (avoid bottled dressings, which have the opposite ratio) and starting your dinner with vinaigrette-dressed salad or steamed vegetables.

4. Spice it up
In an often-quoted 2003 study, Pakistani researchers along with Richard Anderson, a scientist with the U.S. Department of Agriculture, found even 1 gram of cinnamon daily reduces blood sugar.

Subsequent U.S. studies haven’t confirmed the benefits of the spice or cinnamon supplements, but diabetes experts still recommend adding it to your diet.

“It can’t hurt, sprinkled on toast or whatever,” Johnston says.
5. Drink more coffee
Hold on to your mugs: An 18-year, 125,000-participant study (84,276 were women) by the Harvard School of Public Health showed that women who drank six or more cups of coffee per day reduced the risk of type 2 diabetes by nearly 30% – although that much coffee can pose other health risks. Coffee has lots of antioxidants, including chlorogenic acid and magnesium (which can improve sensitivity to insulin), and was found to be better than decaffeinated coffee, though decaf also had some positive effects.

6. Eat your veggies
Experts differ on the best diet to keep diabetes at bay, but all agree you should eat vegetables – and some fruits, beans, nuts and seeds too.

Dr. Vagnini proposes a low-carb, low-salt version of the Mediterranean diet, which is rich in fish, healthy fats like olive oil and spices.

The ADA recommends a nutrient-dense diet (high in vitamins, minerals and fiber, and low in saturated and trans fats) that promotes weight control.
7. Trade meat for soy
If red meat is your main source of protein, replace some of your standbys with soy-based foods, like these 10 tofu dishes and soy burgers.

If that’s hard to swallow, consider this: A major study evaluating more than 37,000 women, conducted by Brigham and Women’s Hospital in Boston, found that eating red meat increases risk of type 2 diabetes in women. Processed meats like hot dogs were found to further increase risk in the 8.8-year study.

8. Skip the sweet drinks
Drinking large quantities of sugar in a few quick gulps creates a blast your body may not be able to handle.

In a Harvard study following 90,000 female nurses over eight years, those who had one or more servings a day of sugar-sweetened soft drinks or fruit punch were twice as likely to develop diabetes. (Weight gain from the drinks was a factor too.)

Diet soda can make you hungrier and leave you craving sugar, Dr. Vagnini says.

9. Reduce stress
Although research is underway to determine if stress raises blood sugars, many experts believe it does, including Richard Surwit, Ph.D., the chief of medical psychology at the Duke University School of Medicine, who wrote a book about managing emotions to control blood sugar, The Mind-Body Diabetes Revolution (Da Capo Press).

10. Soak up some sun
Vitamin D, which we get from sun exposure, plays a role in insulin sensitivity and secretion, leading researchers at Loyola University Chicago to conclude it may prevent or delay the onset of diabetes – and reduce complications for those already diagnosed. If you’re reducing sun time, other good sources are low-fat dairy, milk and fish.

Or take vitamin D supplements.

Dr. Vagnini recommends 5,000 units per day in tablet form to his patients, but consult your doctor to find the right dose for you.

13. Check your levels
The ADA recommends blood glucose screening for everyone 45 and older. Generally, this testing is repeated every three years. But if you have known risk factors (like high blood pressure or obesity), discuss them with your doctor – she may want to test you earlier or more frequently.

Myth vs. Fact: How Much Do You Know About Diabetes?
In the United States alone, 23.6 million people have diabetes. And 5.6 million of them don’t even know it. Unfortunately, misinformation about diabetes is rampant – and mixing up the facts about this disease can have dire consequences. Are you confused about diabetes? Test your knowledge with our diabetes quiz.

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